Histopathological substrate of increased T2 signal in the anterior temporal lobe white matter in temporal lobe epilepsy associated with hippocampal sclerosis.

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY
Epilepsia Pub Date : 2024-11-06 DOI:10.1111/epi.18162
Ricardo C Wainberg, William Alves Martins, Francine H de Oliveira, Eliseu Paglioli, Ricardo Paganin, Ricardo Soder, Rafael Paglioli, Thomas M Frigeri, Matteo Baldisseroto, André Palmini
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Abstract

Objective: This study was undertaken to analyze the histology underlying increased T2 signal intensity (iT2SI) in anterior temporal lobe white matter (aTLWM) epilepsy due to hippocampal sclerosis (TLE/HS).

Methods: Twenty-three patients were included: 16 with increased T2 signal in the aTLWM and seven with HS only. Magnetic resonance imaging (MRI) findings were consistent across two neuroradiologists (kappa = .89, p < .001). Quantification of neuronal cells, astrocytes, oligodendrocytes, and vacuolization in the white matter of temporal lobe specimens was performed by immunohistochemistry (neuronal nuclear antigen, glial fibrillary acidic protein, oligodendrocyte transcription factor, and basic myelin protein, respectively). Surgical specimens from TLE/HS patients with and without iT2SI in the aTLWM were compared. Samples of aTLWM were divided into three groups, according to MRI features: G1 = samples of iT2SI, G2 = samples with normal T2 signal intensity from patients without white matter imaging abnormalities, and G3 = samples with normal T2 signal intensity adjacent to areas with iT2SI.

Results: Patients with increased T2 signal had a significantly younger age at epilepsy onset (p < .035). Histological analysis revealed a higher percentage of vacuolar area in these patients (p < .004) along with a lower number of ectopic neurons (p = .042). No significant differences were found in astrocyte or oligodendrocyte counts among groups.

Significance: A higher proportion of vacuoles in regions with iT2SI may be the histopathologic substrate of this signal alteration in the white matter of the temporal lobe in patients with TLE/HS. This method of quantifying vacuoles using digital image analysis proved reliable and cost-effective.

与海马硬化相关的颞叶癫痫前颞叶白质中 T2 信号增加的组织病理学基础。
研究目的本研究旨在分析海马硬化导致的前颞叶白质(aTLWM)癫痫(TLE/HS)T2信号强度增加(iT2SI)的组织学基础:纳入23名患者:方法:共纳入23名患者:16名aTLWM中T2信号增高的患者和7名仅患有HS的患者。两名神经放射学专家的磁共振成像(MRI)结果一致(kappa = .89,p 结果:T2信号增高的患者的T2信号比TLE/HS患者的T2信号高:T2信号增高的患者癫痫发病年龄明显较小(p 有意义:iT2SI区域空泡比例较高可能是TLE/HS患者颞叶白质信号改变的组织病理学基础。事实证明,这种利用数字图像分析量化空泡的方法既可靠又经济。
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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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